011
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Christine Fulton 9
Jessica Fulton fj;>
Date Received: 1- / JL / Jft-
FOIL Ser. #: 0 U
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
-L/JL/~
UM
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied: -L / --.LL / .J.L
Closed by:
}J{LA
Date:
-L / J.L / .1...d:::'
Notes:
Name: j/ L
Address: yO' /Or:' D 1-//1/ I<D
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Agency or firm:
Telephone#: (fii5'J~85'f7 FAX#: ( )_-
Email address:
Amount Due: ~ Pages for a total of $ ()."5 0
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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Co ~~C1-o3-06q()6S-
FORMAT OF RECORD (if available)
o I request to be notified when I can come to inspect the record(s) described above
o I request copies of the records described above and agree to pay the cost of such records in
accordance with the fee schedule on the back of this application
o I request that the records be sent via e-mail to the address listed above
[] I request that the records be faxed to the number listed above